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Sentinel-Lymph-Node Surgery Safe, Effective Option

Is alternative to axillary-lymph-node dissection in breast cancer patients with negative lymph nodes

TUESDAY, Sept. 21 (HealthDay News) -- Outcomes for women with breast cancer with clinically negative lymph nodes who undergo sentinel-lymph-node (SLN) surgery are clinically equivalent to outcomes for those who undergo the more invasive axillary-lymph-node dissection (ALND), according to a study published online Sept. 21 in The Lancet Oncology.

David N. Krag, M.D., of the University of Vermont in Burlington, and colleagues in the National Surgical Adjuvant Breast and Bowel Project trial B-32 randomized 5,611 women with breast cancer to either SLN resection and ALND, or SLN resection alone (with ALND only for those whose SLNs were positive). In eight years of follow-up, the researchers assessed overall survival, disease-free survival, and side effects.

Among the 3,986 SLN-negative patients followed, the researchers noted 309 deaths, including 140 of 1,975 subjects undergoing SLN resection and ALND, and 169 of 2,011 subjects undergoing SLN resection only. Estimates for overall survival in the two groups were 91.8 and 90.3 percent, respectively, and estimates for disease-free survival were 82.4 and 81.5 percent, respectively. There were fewer deficits in arm function, fewer sensory problems, and less lymphoedema in the SLN resection-only subjects.

"Overall survival, disease-free survival, and regional control were statistically equivalent between groups. When the SLN is negative, SLN surgery alone with no further ALND is an appropriate, safe, and effective therapy for breast cancer patients with clinically negative lymph nodes," the authors write.

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